Tag: U.S. Diplomats medical problems

There have been several recent developments regarding the U.S. and Canadian diplomats who have suffered injuries while serving in Cuba.

First, the two counties’ diplomats have sued their respective governments.

The Canadian lawsuit in Toronto on February 6 alleges that the Canadian government was slow to respond to complaints about these injuries and has failed to provide sufficient medical care.The suit seeks (CAN)$ 28 million [(US)$ 21]in damages on behalf of 14 diplomats, spouses and their children.

The U.S. lawsuit, which was commenced on February 7 by some of the affected U.S. diplomats, is a Freedom of Information Request to obtain documents related to the State Department’s Accountability Review Board’s investigation of the situation.

Second, the State Department has commissioned the National Academy of Sciences, Engineering, and Medicine to conduct a new study to understand “the possible causes of these cases and approaches for future incidents, whether of an apparent acoustic nature or a different environmental or clinical presentation.” This investigation will look at “health monitoring, medical interventions, risk assessment and exposure mitigation for overseas locations that may present a higher risk of adverse health effects.”

On January 30, the Canadian foreign ministry (Global Affairs Canada) announced that another of its diplomats in Havana had fallen mysteriously ill. [1]

This is the 14th such case. “To date, no cause has been identified.” As a result, Canada is removing up to half of its embassy staff.

The Canadian statement added, “Canada has a positive and constructive relationship with Cuba. We have had close cooperation with the Cuban authorities since the health concerns of our employees posted in Havana first surfaced in the spring of 2017.”

Cuba’s Ambassador to Canada, Josefina Vidal, said Cuba “understands the obligations of the government of Canada to protect its diplomatic personnel in any part of the world, and to try to find answers to the health symptoms reported in Cuba, [which] remains committed to preserving the good state of relations and expanding its ties with a country to which strong ties of friendship and cooperation unite us.”[2]

Nevertheless, the Cuban Ambassador found the Canadian decision to reduce its Havana Embassy staffing “incomprehensible.” It does “not help solve or find answers to the health symptoms that diplomats have reported and will have an inevitable impact on the conduct of relations.” Instead, this decision “favors those in the United States who use this issue to attack and discredit Cuba. It is known that individuals with a high responsibility for foreign policy in the United States are committed to provoking a climate of bilateral tension and being able to point Cuba as a threat.”

As previously reported, some of the U.S. diplomats who suffered injuries in Cuba complained that they had heard strange sounds when they were being injured.[1]

Now two scientists–Alexander Stubbs of the University of California, Berkeley and Fernando Montealegre-Z of the University of Lincoln in England—claim that male Indies Short-Tailed Crickets emitted these sounds during courtship.[2]

Such sounds, however, the scientists say, did not cause any of the injuries sustained by the diplomats.

On December 12, 2018, physicians at the University of Miami published a scientific study concluding that the U.S. diplomats in Cuba who have reported certain medical problems over the last two years suffered damage to the part of the inner ear responsible for balance. [1]

Dr. Michael E. Hoffer, the director of the university’s Vestibular and Balance Program and lead author of the study, said, “These people were injured. We’re not sure how. The injury resulted in ear damage and some trouble thinking.”

Dr. Hoffer added, “What we noticed is universal damage to the gravity organs in the ear. The ear has a bunch of different balance organs — and two of them are gravity organs — and those are damaged in everyone.” After suffering the damage, he said, the patients’ bodies spend so much energy trying to stay balanced that it wipes them out.“That’s very fatiguing. And it doesn’t leave a lot left over to remember where you put your keys.”

To date the U.S. has not identified any known cause for these injuries. The University of Miami study said, “it would be imprudent to exclude any potential directed or non-directed energy sources at this time.”

For nearly two years the U.S. publicly remains baffled by the causes of the medical problems of 26 U.S. diplomats stationed in Cuba. Twelve Canadian diplomats while in Cuba also have suffered similar problems, and the Canadian government publicly also remains baffled.[1]

Now the Canadian government has engaged brain injury experts from the Brain Repair Center, affiliated with Dalhousie University, the Nova Scotia Health Authority and the Isaak Walton Killam Health Center, to investigate the symptoms and possible causes that left Canadian diplomats and family members with a series of mysterious symptoms.[2]

On August 30, the U.S. Secretary of State submitted a report to Congress about the Cuba Accountability Review Board’s (ARB) investigation and report regarding the State Department’s responses to medical problems of some U.S. diplomats in Cuba. [1]

The ARB’s 30 recommendations, all of which were accepted by the Department were grouped into the following six areas:

“Accountability: The ARB found the lack of a single designated senior-level Department official with responsibility for responding to the attacks resulted in insufficient communications with employees and impeded coordination within the Department and with other agencies. The ARB recommended elevating the overall responsibility for the Cuba response to the Deputy Secretary of State. In May, the Deputy Secretary – at the Secretary’s request – established the interagency Health Incidents Response Task Force to direct a multi-agency response to the unexplained health incidents that have affected U.S. government personnel and family members stationed overseas. The Department has committed to reviewing – and revising when necessary – procedures for ensuring continued senior-level leadership at all times, as well as validating and strengthening guidance for Chiefs of Mission (including Chargés), emphasizing their responsibility for the safety and security of personnel abroad. The Department is establishing a new position solely responsible for longer-term outreach and assistance to personnel affected by these incidents.”

“Interagency Coordination: The ARB found that interagency information sharing should be enhanced to improve understanding of the problem and more coordinated initial responses. The ARB noted the Department’s well-established and successful procedures for dealing with crisis situations and highlighted the benefit of reviewing its processes for communication and coordination with interagency partners, as well as reminding leaders of these processes. The Department agrees with these recommendations and will re-issue guidance outlining the various tools and processes Washington and posts abroad have available to prepare for and respond to crisis situations. The Department will reinforce the importance of proper and timely implementation of these procedures, and is committed to working with interagency partners to ensure coordination of efforts on the response to the incidents.”

“Medical Issues: The ARB found the Department’s Bureau of Medical Services provided competent and professional response to an unprecedented situation, but they had insufficient resources to support the long-term care and follow-up needed for these types of incidents. To address the ARB’s recommendations, the Department, in coordination with other appropriate U.S. government agencies, is identifying and reviewing applicable legal authorities and resources for long-term medical follow-up and treatment for U.S government personnel and families impacted by the incidents in Cuba, and will seek legislative remedies where necessary. The Department is also working closely with the Department of Labor to allow for the proper adjudication of workers’ compensation claims from Department personnel. Additionally, the ARB recommended the Department make pre-departure and post-assignment medical screening a mandatory condition for assignment to, or temporary duty in, Havana. The Department is in the process of developing policy modifications to make such screenings mandatory. The ARB also recommended the Department engage the Centers for Disease Control and Prevention (CDC) to undertake a comprehensive medical and epidemiologic study of the symptoms and clinical findings related to the incidents in Cuba. The Department is working with the CDC to support such an analysis.”

“Internal Communication and Information Sharing: The ARB made several recommendations to facilitate communication and information sharing in the case of any future incidents. The Department is implementing the ARB’s recommendations, with the goal of: clarifying responsibilities, providing centralized points of contact to coordinate efforts, establishing clear notification protocols, and ensuring as much transparency as possible to those affected, taking into account the privacy of the individuals involved as well as sensitive law enforcement and national security information.”

“Risk/Benefit Analysis: The ARB made several recommendations to ensure the Department enacts its already established processes to conduct formal risk/benefit analyses and ensure any actions balance Department priorities with risk management. The Department is implementing these recommendations, and taking steps to enhance broader awareness of these processes throughout the Department. For example, the Department has processes to conduct an analysis at least once annually of mitigation measures and residual risks associated with operating at high threat, high risk posts and at those posts on Authorized or Ordered Departure for 90 days or more due to security reasons. The Department will continue to implement this approach.”

“Diplomatic Security: The ARB found individual offices within the Bureau of Diplomatic Security (DS) responded to the Cuba incidents reports based on their respective areas of expertise, but that the overall response would have benefitted from the formulation and resourcing of a formal DS multi-disciplinary working group. The Department agreed, and DS formed a Health Incidents Response Working Group with members from all relevant DS offices reporting to the DS Assistant Secretary. This working group has increased communication among the various interagency investigative representatives, and ensured action items are addressed quickly and comprehensively. Additionally, to address future potential unexplained health-security incidents, the Department developed standardized formal guidance, leveraging existing crisis response processes, designed to ensure a consistent response from all agencies at post. All posts are reviewing and updating their emergency action plans to incorporate this guidance. The ARB also suggested the Department review its training programs for security personnel. DS is in the process of reviewing its training and briefing programs to ensure security officers have adequate knowledge of these types of incidents prior to going to post.

The report to Congress stated that the Department already had implemented half of the ARB’s 30 recommendations and is actively working to complete the rest.

“The ARB’s mandate was not to determine the cause of the unexplained health incidents.” (Emphasis added.)

On August 23, the U.S. State Department revised its Travel Advisory for Cuba. Now, Cuba is “Level 2: Exercise Increased Caution.[1] The new Advisory states the following:

“Exercise increased caution in Cuba due to attacks targeting U.S. Embassy Havana employees resulting in the drawdown of embassy staff.”

“Numerous U.S. Embassy Havana employees appear to have been targeted in specific attacks. We are unable to identify the source. Many of these employees have suffered injuries. Affected individuals have exhibited a range of physical symptoms including ear complaints and hearing loss, dizziness, headaches, fatigue, cognitive issues, visual problems, and difficulty sleeping.”

“Attacks have occurred in U.S. diplomatic residences (including a long-term apartment at the Atlantic) and at Hotel Nacional and Hotel Capri in Havana.”

“The U.S. Embassy in Havana is operating with reduced staffing. Family members cannot accompany U.S. government employees who work in Cuba.

“If you decide to travel to Cuba:

Avoid Hotel Nacional and Hotel Capri.

If you experience any acute auditory or sensory phenomena, immediately move to another area.

S. citizens who travel abroad should always have a contingency plan for emergency situations. Review the Traveler’s Checklist.”

This action supersedes and thereby cancels the Level 3 Category issued this January that advised Americans to reconsider travel to the island. Thus, the new Advisory is an upgrade, and its legend “Exercise Increased Caution” implicitly means increased caution over that for the Level 1 (top) category. [2]

Orna Blum, a spokeswoman for the State Department’s Bureau of Western Hemisphere Affairs, said, “The Department conducted a comprehensive risk assessment for U.S. private citizen travelers in Cuba and decided that a Level 2 travel alert was appropriate. The health attacks appear to be directed at U.S. government personnel and occur mainly in the residences of embassy staff.”

Reactions

“We are pleased that the State Department has made this common-sense decision,” said Martha Honey, executive director of the Center for Responsible Travel (CREST), a coalition of U.S. tour operators and organizations. “Cuba is one of the safest countries in the world, and people-to-people exchanges, which began to flourish under the Obama administration, ground almost to a halt when the travel restrictions were imposed last year.”

A similar reaction came from Collin Laverty, president of Cuba Educational Travel, who said, “It is a breath of fresh air in a highly politicized process of confusion, anxiety and speculation which led to an excessive measure by the State Department.” He said the initial decision to elevate the Cuban travel advisory was politically motivated and that now the United States is “righting its wrong by assessing that Americans need not reconsider travel to Cuba in order to stay safe.”